他克莫司滴眼液治疗免疫性疾病相关性干眼的系统评价

Tacrolimus eye drops in the treatment of patients with dry eye associated immunologic diseases:a systematic review

目的 观察他克莫司滴眼液治疗免疫性疾病相关性干眼的有效性和安全性。方法 系统检索PubMed、Embase、The Cochrane Library、ClinicalTrials. gov、中国知网、万方等中英文数据库,对已发表的他克莫司滴眼液治疗干眼的随机对照试验进行系统分析。结果 最终纳入4项随机对照研究(RCT),其中2项RCT研究了0.1%他克莫司滴眼液与玻璃酸钠滴眼液联用治疗移植物抗宿主病相关干眼的疗效,他克莫司组的干眼症状评分、泪膜破裂时间、泪液分泌试验和角膜荧光染色均较治疗前显著改善,且明显优于玻璃酸钠组。另2项RCT单独使用0.03%他克莫司滴眼液治疗干燥综合征相关干眼,相较于安慰剂或载体,他克莫司治疗组的角膜染色评分明显改善。结论 他克莫司可改善免疫性疾病相关性干眼的症状和体征,尤其是角膜屏障功能。

Objective To evaluate the efficacy and safety of Tacrolimus eye drops in the treatment of dry eye(DE)related to immunologic diseases. Methods The systematic literatures were searched in PubMed,Embase,The Cochrane Library,Clinical Trials,CNKI,WanFang and other Chinese and English database. The randomized controlled trials(RCT)about Tacrolimus eye drops for the treatment of dry eye were included. The enrolled studies were qualitatively analyzed with descriptive analysis method. Results A total of 4 RCTs were enrolled. Two studies investigated the efficacy of combination therapy of 0.1% Tacrolimus eye drops and artificial tear on dry eye caused by graft versus host diseases. After the treatments,the ocular surface disease index score,tear break-up time,Schirmer’s test and corneal fluorescein staining in the Tacrolimus group were significantly improved compared with those before treatment,and were significantly better than those in sodium hyaluronate group. In the other two RCTs,0.03% Tacrolimus eye drops were used to treat dry eyes caused by Sjogren’s syndrome. Compared with placebo or vehicle,the corneal staining score in tacrolimus group was significantly improved. Conclusions Tacrolimus eye drop has an effect on subjective symptoms,and can improve tear film indicators,especially the corneal barrier function.